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Organization
GS PHYSICIAN SERVICES
Active
Organization
GS PHYSICIAN SERVICES
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KRISTINE GLOVER (EVP/COO)
(903) 315-2504
Entity
Organization
Contact information
Practice address
1600 BROADWAY AVE, GLADEWATER, TX 75647-5040
(903) 315-4119
(903) 315-3778
Mailing address
PO BOX 4207, LONGVIEW, TX 75606-4207
(903) 315-4105
(903) 315-3778
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
—
—
207R00000X
Internal Medicine Physician
—
—
207RG0100X
Gastroenterology Physician
—
—
207T00000X
Neurological Surgery Physician
—
—
208000000X
Pediatrics Physician
—
—
2084P0800X
Psychiatry Physician
—
—
208600000X
Surgery Physician
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
136455610
—
TX
Enumeration date
05/04/2006
Last updated
12/01/2016
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